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General NPI Number Information
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NPI Number | 1801844022
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Entity Type | Organization
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Legal Business Name | ENDOCRINE CONSULTANTS NORTHWEST I, PLLC
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 10/11/2007
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Provider Practice Location Address
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Address Line | 1628 S MILDRED ST SUITE 104
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City | TACOMA
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State | WA
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Zip | 98465-1627
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Country | US
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Telephone | 253-565-6777
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Fax | 253-565-8777
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Provider Business Mailing Address
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Address Line | 1628 S MILDRED ST SUITE 104
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City | TACOMA
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State | WA
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Zip | 98465-1627
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Country | US
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Telephone | 253-565-6777
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Fax | 253-565-8777
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Authorized Official
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Title or Position | PARTNER
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Name | K. DAVID MCCOWEN
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Credential | M.D.
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Telephone | 253-565-6777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State | WA
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